The Effect of Burnout on Medical Errors and Professionalism in First-Year Internal Medicine Residents

Kwah, Jason; Weintraub, Jennifer; Fallar, Robert; Ripp, Jonathan

doi:10.4300/jgme-d-15-00457.1

Cited by 37 publications

(34 citation statements)

References 18 publications

(26 reference statements)

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“…Physician burnout has negative consequences not only for the physicians suffering from it but also for patients and organizations. Studies have shown that burnout can result in an increase in medical errors, reduced quality of patient care and professionalism, and decreased patient satisfaction (12)(13)(14)(15)(16)(17). Within healthcare organizations, burnout is associated with lower productivity including decreased work effort, high job turnover, and early retirement (18)(19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

A Randomized Controlled Trial of Balint Groups to Prevent Burnout Among Residents in China

et al. 2020

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Introduction: Burnout is highly prevalent among residents and is associated with negative outcomes for patients, organizations, and physicians. Balint groups have been shown to be an effective strategy to alleviate physicians' burnout. The purpose of this study was to examine the effectiveness and feasibility of Balint groups in preventing burnout among residents in training programs in China.Methods: 36 resident physicians in their first year of residency at a comprehensive hospital in China were randomly assigned to two groups. Physicians in the intervention group participated in 2 lectures and 10 Balint sessions for 6 months, while participants in the control group were placed on a waitlist for future Balint sessions. All 36 participants completed burnout and job satisfaction measures pre and post-intervention.Results: The mean burnout subscale scores for EE and DP decreased, and the scores for PA and job satisfaction increased after Balint group participation. However, paired t-test results revealed there were no statistically significant differences between pre and posttest scores for EE (t = −1.323, p = 0.203), DP (t = −0.727, p = 0.477), PA (t = 0.716, p = 0.484, and job satisfaction (t = 0.282, p = 0.781) for the intervention group. For the control group, the burnout subscale scores for EE (t = 2.312, p = 0.034) and DP (t = 2.898, p = 0.019) increased, and there were statistically significant differences between pre and posttest. PA (t = −0.717, p = 0.483) and job satisfaction (t = −0.241, p = 0.812) scores decreased although there were no significant differences seen between the pre and posttest. Independent t-test results demonstrated statistically significant differences in scores for EE (t = −2.662, p = 0.013) and DP (t = −2.433, p = 0.020) between intervention and control group. However, there were not statistically significant differences between groups for scores in PA (t = 1.013, p = 0.318) and job satisfaction (t = 0.367, p = 0.716). All 18 participants in the intervention group reported that Balint groups were helpful and that they would be willing to attend future sessions. Overall satisfaction with the Balint group program was over 80%.Conclusion: Balint groups are an efficacious, feasible, standardized method of preventing resident burnout. Residents in China may benefit from Balint group implementation in residency training programs.

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Section: Introductionmentioning

confidence: 99%

A Randomized Controlled Trial of Balint Groups to Prevent Burnout Among Residents in China

et al. 2020

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“…In addition to the negative clinical impacts on individuals, burnout negatively affects workplace organizations. In general, burnout among health care providers has been linked to increased absenteeism and attrition, as well as reduced quality of care and more frequent medical errors, potentially compromising patient safety …”

Section: Introductionmentioning

confidence: 99%

“…In general, burnout among health care providers has been linked to increased absenteeism and attrition, as well as reduced quality of care and more frequent medical errors, potentially compromising patient safety. [6][7][8][9] According to the Job Demands-Resources Theory, burnout most often results from a prolonged, ongoing imbalance between work demands and job-related resources, whereby work demands significantly exceed job-related resources. 10 Job demands are defined as physical, social, or organizational aspects that require sustained physical or mental effort (eg, physical workload, time pressure, physical environment).…”

Section: Introductionmentioning

confidence: 99%

The association of job demands and resources with burnout among emergency medical services professionals

Crowe¹,

Fernández

Pepe³

et al. 2020

JACEP Open

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Objective Although burnout has been linked to negative workplace‐level effects, prior studies have primarily focused on individuals rather than job‐related characteristics. This study sought to evaluate variation in burnout between agencies and to quantify the relationship between burnout and job‐related demands/resources among emergency medical services (EMS) professionals. Methods An electronic questionnaire was sent to all licensed, practicing EMS professionals in South Carolina. Work‐related burnout was measured using the Copenhagen Burnout Inventory. Multivariable generalized estimating equations were used to estimate odds ratios (ORs) for specific job demands and resources while adjusting for confounding variables. Composite scores were used to simultaneously assess the relationship between burnout and job‐related demands and resources. Results Among 1271 EMS professionals working at 248 EMS agencies, the median agency‐level burnout was 35% (interquartile range [IQR]: 13% to 50%). Job‐related demands, including time pressure, were associated with increased burnout. Traditional job‐related resources, including pay and benefits, were associated with reduced burnout. Less tangible job resources, including autonomy, clinical performance feedback, social support, and adequate training demonstrated strong associations with reduced burnout. EMS professionals facing high job demands and low job resources demonstrated nearly a 10‐fold increase in odds of burnout compared with those exposed to low demands and high resources (adjusted OR [aOR]: 9.50, 95% confidence interval [CI]: 6.39–14.10). High job resources attenuated the impact of high job demands. Conclusion The proportion of EMS professionals experiencing burnout varied substantially across EMS agencies. Job resources, including those reflective of organizational culture, were associated with reduced burnout. Collectively, these findings suggest an opportunity to address burnout at the EMS agency level.

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“…12 Most studies evaluating health care professional burnout and quality of care have found an inverse relationship, 13–19 although this finding has not been universal. 20–22 Poor physician well-being in other domains (eg, fatigue, depression, poor quality of life) has been linked to reduced patient safety in many, 16,18,22,23 but not all, 21,24 studies. Most reports have been cross-sectional observational studies, and a nuanced understanding of the potentially bidirectional connection between physician well-being and patient safety remains in its infancy.…”

mentioning

confidence: 99%

Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical Errors

Tawfik¹,

Profit²,

Morgenthaler³

et al. 2018

Mayo Clinic Proceedings

482

349

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Objective: To evaluate physician burnout, well-being, and work unit safety grades in relationship to perceived major medical errors. Participants and Methods: From August 28, 2014, to October 6, 2014, we conducted a population-based survey of US physicians in active practice regarding burnout, fatigue, suicidal ideation, work unit safety grade, and recent medical errors. Multivariate logistic regression and mixed-effects hierarchical models evaluated the associations among burnout, well-being measures, work unit safety grades, and medical errors. Results: Of 6695 responding physicians in active practice, 6586 provided information on the areas of interest: 3574 (54.3%) reported symptoms of burnout, 2163 (32.8%) reported excessive fatigue, and 427 (6.5%) reported recent suicidal ideation, with 255 of 6563 (3.9%) reporting a poor or failing patient safety grade in their primary work area and 691 of 6586 (10.5%) reporting a major medical error in the prior 3 months. Physicians reporting errors were more likely to have symptoms of burnout (77.6% vs 51.5%; P<.001), fatigue (46.6% vs 31.2%; P<.001), and recent suicidal ideation (12.7% vs 5.8%; P<.001). In multivariate modeling, perceived errors were independently more likely to be reported by physicians with burnout (odds ratio [OR], 2.22; 95% CI, 1.79–2.76) or fatigue (OR, 1.38; 95% CI, 1.15–1.65) and those with incrementally worse work unit safety grades (OR, 1.70; 95% CI, 1.36–2.12; OR, 1.92; 95% CI, 1.48–2.49; OR, 3.12; 95% CI, 2.13–4.58; and OR, 4.37; 95% CI, 2.06–9.28 for grades of B, C, D, and F, respectively), adjusted for demographic and clinical characteristics. Conclusion: In this large national study, physician burnout, fatigue, and work unit safety grades were independently associated with major medical errors. Interventions to reduce rates of medical errors must address both physician well-being and work unit safety.

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The Effect of Burnout on Medical Errors and Professionalism in First-Year Internal Medicine Residents

Abstract: Background Burnout is a common issue in internal medicine residents, and its impact on medical errors and professionalism is an important subject of investigation.

Cited by 37 publications

References 18 publications

A Randomized Controlled Trial of Balint Groups to Prevent Burnout Among Residents in China

A Randomized Controlled Trial of Balint Groups to Prevent Burnout Among Residents in China

The association of job demands and resources with burnout among emergency medical services professionals

Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical Errors

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